RT Journal Article
SR Electronic
T1 Epidemiology of infections and antimicrobial use in Greek Neonatal Units
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP F293
OP F297
DO 10.1136/archdischild-2018-315024
VO 104
IS 3
A1 Despoina Gkentzi
A1 Christina Kortsalioudaki
A1 Benjamin Campbell Cailes
A1 Theoklis Zaoutis
A1 John Kopsidas
A1 Maria Tsolia
A1 Nikos Spyridis
A1 Soultana Siahanidou
A1 Kosmas Sarafidis
A1 Paul T Heath
A1 Gabriel Dimitriou
A1 ,
YR 2019
UL http://fn.bmj.com/content/104/3/F293.abstract
AB Objective To describe the epidemiology of neonatal infections and of antimicrobial use in Greek Neonatal Units (NNUs) in order to develop national, evidence-based guidelines on empiric antimicrobial use for neonatal sepsis in Greece.Design Retrospective analysis of prospectively collected infection surveillance data from 2012 to 2015, together with a Point Prevalence Survey (PPS) on antimicrobial use and the collection of data on local empiric antimicrobial policies.Setting 16 NNUs in Greece participating in the neonIN infection surveillance networkPatients Newborns in participating NNUs who had a positive blood, cerebrospinal fluid or urine culture and were treated with at least 5 days of antibiotics.Results 459 episodes were recorded in 418 infants. The overall incidence of infection was 50/1000 NNU-admissions. The majority of episodes were late-onset sepsis (LOS) (413, 90%). Coagulase-negative Staphylococci (80%) were the most common Gram-positive organisms causing LOS and Klebsiella spp (39%) the most common Gram-negative. Nearly half (45%) of the Klebsiella spp were resistant to at least one aminoglycoside. The PPS revealed that 196 of 484 (40%) neonates were on antimicrobials. The survey revealed wide variation in empiric antimicrobial policies for LOS.Conclusions This is the largest collection of data on the epidemiology of neonatal infections in Greece and on neonatal antimicrobial use. It provides the background for the development of national evidence-based guidelines. Continuous surveillance, the introduction of antimicrobial stewardship interventions and evidence-based guidelines are urgently required.